U.S. prescription drug spending increased 12.7% to $915.2 billion in 2025 and is projected to exceed $1 trillion in 2026, continuing to outpace other countries and drive healthcare costs higher, according to an April 29 report from the American Society of Health-System Pharmacists.
The U.S. already leads globally in drug spending, with per capita costs around $2,000 in 2022 — far higher than other developed markets — while Medicaid drug spending rose 46% over five years, driven in part by GLP-1s and specialty therapies.
The report highlights several key drivers behind the increase. Here are five things to know about the latest drug spending trends:
- GLP-1 drugs are a major driver. Tirzepatide spending reached $62.8 billion in and semaglutide reached $59.1 billion, while GLP-1 drugs totaled $131.9 billion in spending and accounted for 14% of overall spending.
- Top drugs far outpace others. Apixaban spending totaled $29.2 billion, significantly lower than the leading GLP-1 therapies.
- Clinic spending is rising faster than hospitals’. Clinic drug spending increased 19% to $190.5 billion in 2025, compared to a 9.6% increase to $42.9 billion among nonfederal hospitals.
- Spending is expected to increase in 2026. Overall drug spending is projected to grow 10% to 12%, with clinics expected to see 14% to 16% growth and hospitals 4% to 6%.
- Oncology drugs drove spending growth. Cancer therapies remained the largest and fastest-growing category across settings, led by precision oncology, immune checkpoint inhibitors and antibody-drug conjugates, with biosimilar use increasing in 2025.
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